An Inside Look into the Role of a Blue Shield of California Pharmacist

Author: Alison K Lum , Vice President of Pharmacy Services, Pharmacy Strategic Operations and Compliance, Blue Shield of California

In honor of National #Pharmacist Day, we'd like to take a moment to thank our 100+ pharmacists at Blue Shield of California, who work to make meaningful changes in the lives of our members each day. We cannot thank them enough for going above and beyond the call of traditional pharmacist duties to enrich, serve, and advocate for our valued members.

To gain deeper insight into the work that our Blue Shield pharmacists do, we sat down with two pharmacists to discuss what a typical workday looks like, what inspired them to start their careers, what they find most rewarding about their jobs, how they feel about working at Blue Shield, and more.

What first inspired you to become a pharmacist?

"I've always had a passion for the sciences," says Christine Song, drug utilization review pharmacist for Blue Shield of California Promise Health Plan. "Growing up, I've always loved learning anything health-related or medical-related."

She also wanted to be close to her family and wanted to choose a career path that gave her a good work-life balance.

“I felt like pharmacy would be a good career choice that would allow me to pursue my passion for the sciences but also maintain that work-life balance that I wanted.”

Cleo Mutebi, Shield Concierge clinical pharmacist, started her healthcare career as a nurse. Working with a lot of geriatric patients, she was often asked questions about the medications she was administering. "I always had an answer for them," she recalls, "like, 'It's going to lower your blood pressure,' but that question always kind of bothered me." She wanted to be able to give her patients more information, such as explaining how the medication works once it's in the body and how the medication is removed from the body.

"Based on that, I thought the next logical thing to do at the time was to become a pharmacist." As a life-long learner, "that's the approach I took to getting an in-depth understanding of exactly what was happening once the medication was consumed."

Cleo and Christine have both been working at Blue Shield for more than six years. Christine, a pharmacist of 13 years, started working at Care1st Health Plan, which became Blue Shield Promise Health Plan in 2019. She currently works as a drug utilization review pharmacist. Cleo began her career with Blue Shield as a drug utilization review pharmacist, a role she held for three and a half years before taking an almost two-year sabbatical, then returning in 2019 to take on her current role as a Shield Concierge clinical pharmacist.

What made you want to work for Blue Shield?

"I have always been excited about impacting health outcomes," says Cleo Mutebi. She continues, "Blue Shield's mission to create a health system worthy of our family and friends that is sustainably affordable aligns with my values. Blue Shield is the place I feel my acquired clinical experience as an inpatient and outpatient community pharmacist can have the most significant impact on population-based health outcomes."

Christine Song started her career in retail pharmacy and came to Blue Shield hoping to find a greater work-life balance. As to her feelings about working with Blue Shield, she states, "Oh, I love it. The company vision, their model, and how they focus on wellness and work-life balance creates happy employees. Happy employees work better." She continues, "Blue Shield offers a lot of really unique benefits that other companies don't, and they really care about their employees' well-being and treat me like a person instead of a number." Christine also mentions that she enjoys the ability to work from home full-time, which allows her to balance her time with the family better. 

Christine continues, "Management gives me a lot of autonomy to do my job and do it well. I like the fact that they trust me, and they don't micromanage me because they trust me. Even though each day is very independent, l never feel alone." She states that she has a "very caring and approachable team and leader that I can always go to if I need help, or have questions, or need guidance on anything. I never feel like I have to navigate my day alone or feel like I'm lost because there's always someone to help me."

“I feel like I can spend time with my kids, have dinner with them and my husband, and be able to do my duties as a mom and wife while still having a job and being able to focus on my career.”

What does a day-in-the-life of a Blue Shield pharmacist look like?

Christine reflects, "Because we're a large company, I don't wear as many hats as when I worked for smaller organizations. Blue Shield is more focused and specialized." As a drug utilization review pharmacist, a day-in-the-life involves working with prior authorizations. "We review cases to determine whether a medication will be covered based on policies, which may address things such as safety, efficacy, cost-saving alternatives, and benefits. We also attend daily clinical rounds to discuss off-label cases, ask questions, or discuss any issues that arise. And we provide support to doctors and pharmacy technicians needing help with clinical questions or navigating the prior authorization process."

Christine continues, "One of the benefits of working in the prior authorization department is that I'm able to cross-train and learn more about managed care roles outside of my own while working on projects." For the past eight months, I was helping the Pharmacy and Therapeutics Committee Drug Information team. I was able to experience a little bit of what they do, and it was very eye-opening. I would love to be able to participate in more projects like this in the future because I was able to learn so much and see a glimpse of all the things that happen behind the scenes." 

For a Shield Concierge pharmacist, Cleo observes, "Tasks on typical days are centered around members, helping them navigate the healthcare system or any diagnosis or illness they have. It's primarily researching and responding to medication-related questions that could be a variation of things; appropriate use, treatment options, side effects, and lower-cost alternatives based on their condition. We also monitor adherence, safe and effective use of a member's medication regimen through our clinical pharmacy outreach programs. We really take a holistic approach to who the member is."   

As a member of Shield Concierge's holistic, integrated care management team model, Cleo collaborates with nurses, health coaches, social workers, medical directors, and pharmacy technicians." She notes, "We're really trying to personalize and customize the type of care that we give based on a person's needs, so it's not just a general directive to, 'Take your medication,' but, 'Let's understand what else is going on that could impact how you take your medication.' Many members have complex medical histories that require a lot of coordination from different specialists, and this can be extremely overwhelming."  

Cleo is able to help alleviate members' stress by showing them they have someone who understands the healthcare system and can be their advocate. Many members are experiencing stress when they first call Cleo; however, once they've spoken, members feel a sense of relief knowing she is just a phone call away whenever needed. Since Cleo works with an integrated care management team, she and the other Shield Concierge clinicians guide members on how to resolve many of their concerns. She says, "It's so phenomenal, it's such a unique model that is lacking in healthcare – that holistic approach. It's very satisfying knowing when I get off the phone that I've actually helped address every issue, not just the one they called about." 

What advice would you give to those who are pursuing or considering a role with Blue Shield?

Both Cleo and Christine advise prospective pharmacists to learn as much as they can and broaden their skill sets beyond the realm of pharmaceuticals. According to Cleo, "The role of a pharmacist has expanded to include program development, project management, and process improvement. My advice is to acquire additional skills, such as creative thinking, strategic thinking, meeting facilitation, and project management."

Christine says, "Experiences outside of your role can help in ways you wouldn't traditionally imagine. For example, let's say someone learns how to manage people; in the long-term, this could lead to a pharmacy management position." She also advises prospective pharmacists to, "Always keep that curiosity… If you can keep an open mind and are curious, you can explore so many options."

What advice would you give to those who are pursuing or considering a role with Blue Shield?

Cleo says, "Working at Blue Shield truly feels like working with family and friends. If you are looking for an environment where you can be on the forefront of driving positive change and innovation within healthcare, Blue Shield of California is the place for you."

Christine also advises those pursuing or considering a role with Blue Shield to continue to learn as much as they can, broaden their skill sets, and to, "build your resume with new skills and experiences, and network with people who have connections to Blue Shield."

What are your future career goals?

"I love the company," states Christine, "so I really hope to retire from Blue Shield. While I'm here, I want to learn as much as I can by cross-training across the organization to expand my knowledge and skillsets."

Cleo says, "My approach is to be constantly learning and adapting to change. Change creates new opportunities for innovation. I'm excited to be part of the future innovation in pharmacy."

Any final thoughts, advice, or quotes to share?

Christine shares a quote she finds inspiration from: "Life will always get busy, make time to do the things you love." – Lailah Gifty Akita. "…and spend it with the ones you love.", Christine adds. 

Cleo shares that, “Healthcare is evolving, and it’s exciting to see organizations that are challenging the status quo. As pharmacists, we must collaborate, learn, and apply what other industries are doing to fuel innovation and creative thinking.”

She also shares an ancient Chinese proverb: "When the winds of change blow, some people build walls, and others build windmills." -Author Unknown.

Are you interested in joining a team that treats you like a friend or family member while working toward making healthcare more affordable and innovative? We'd love to speak with you.

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